Seizure First Aid

01

M.A.M.I.  —  Clinical Resources

Seizure First Aid

Protocol SZ-01  ·  Reviewed 13 July 2026  ·  Next review July 2027

A seizure is a medical emergency until proven otherwise.

This protocol sets out what to do during a seizure, what to do once it stops, and the situations that require an ambulance. It is written for practitioners working in a clinical setting.

Immediate escalation

Call 000 if any of these apply

  1. The seizure lasts five minutes or longer.
  2. Another seizure begins before recovery.
  3. Consciousness does not return within five minutes of the seizure stopping.
  4. You do not know the person.
  5. There is no Epilepsy Management Plan available.
  6. The person was eating or drinking when it began.
  7. A serious injury has occurred.
  8. The seizure happened in water.
  9. The person may be pregnant.
  10. Anything is inconsistent with their management plan.
01

During the seizure

Protect · Position · Time

Protect the head

Something soft and flat beneath it. A folded jacket.

Roll onto the side

Once practical. Immediately if fluid is in the mouth.

Time it

Five minutes is the ambulance threshold. Use a clock.

  1. Follow their management plan

    If the person is known to you and has an Epilepsy Management Plan, follow it. It overrides this general protocol.

  2. Protect from danger — do not move them

    Make the space safe rather than moving the person. Clear hard or sharp objects from around them. Move the person only if they are in danger where they lie.

  3. Ease the fall if you can

    If they are falling and you are positioned to do so, ease them down.

  4. Protect the head

    Place something soft and flat beneath the head — a folded jacket or jumper.

  5. Turn them on their side when practical

    Roll to the side once it is safe to do so. Do this immediately if there is food, fluid or vomit in the mouth.

  6. Time the seizure

    Note the start time. Five minutes is the threshold for an ambulance. Do not estimate — look at a clock.

  7. Loosen anything tight at the neck

    Collars, ties, lanyards — anything restricting the airway.

  8. Stay, and keep onlookers back

    Remain with the person for the whole seizure. Waking to a crowd is distressing and disorienting.

02

Once the seizure stops

Assess breathing first

  1. Check responsiveness and breathing

    This is the decision point. Everything that follows depends on it.

  2. If unresponsive but breathing normally

    Position in the lateral, side-lying recovery position and ensure the airway is clear. Monitor breathing continuously.

  3. If responsive

    Help them sit or lie on their side. Speak calmly. Explain simply what has happened — confusion afterwards is expected.

  4. Recovery

    Let them rest if they become sleepy, and keep monitoring breathing. Do not give food, drink or medication until they are fully alert. Ensure they get home safely and are not alone.

Critical correction

If they are not breathing normally — start CPR

The rule that you do not perform CPR applies only during the convulsion itself. It does not apply afterwards.

If at any point the person is unresponsive and not breathing normally, call 000 and begin resuscitation following the ANZCOR Basic Life Support flowchart. Do not withhold CPR because a seizure has occurred.

03

Do and do not

The errors that cause harm

Do
  • Stay calm, and keep those around you calm.
  • Stay with the person until they have fully recovered.
  • Time the seizure from the start.
  • Check for medical identification if they are unknown to you.
  • Protect the head.
  • Roll them onto their side once the convulsion stops.
  • Reassure them, and tell them where they are.
Do not
  • Do not restrain or hold the person down. Restraint does not shorten a seizure and causes injury.
  • Do not put anything in the mouth, or force the mouth open. The tongue cannot be swallowed.
  • Do not move the person unless they are in danger where they lie.
  • Do not give food, drink or medication until fully alert.
  • Do not perform CPR during the convulsion — but see the panel above.

Special situation

If the seizure occurs in water

Immediately life-threatening. Support the person with the head tilted so the face stays clear of the water. Remove them from the water as soon as it is safe to do so. Call 000 even if they appear to be breathing — water may have been inhaled.

Scope and limitations

This protocol is an educational resource for practitioners. It is a guide only. It does not replace clinical judgement, your clinic's own emergency procedures, an individual's Epilepsy Management Plan, or nationally accredited first aid certification (HLTAID011 Provide First Aid). Reading this document does not confer competence in first aid or resuscitation.

Sources

  • Australian and New Zealand Committee on Resuscitation (ANZCOR), Guideline 9.2.4 — First Aid Management of a Seizure.
  • Australian and New Zealand Committee on Resuscitation (ANZCOR), Guideline 8 — Cardiopulmonary Resuscitation, Basic Life Support flowchart.
  • Epilepsy Foundation (Australia) — Seizure First Aid.

Where this document differs from the current ANZCOR guidelines, the ANZCOR guidelines prevail. Practitioners should confirm the current version at anzcor.org.

Clinical review. Reviewed by Dr Larissa Miller, Cosmetic Physician, on 13 July 2026. Next scheduled review July 2027. Protocols are reviewed at least annually and after any incident.

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